GPSJ Autumn 2024 ONLINE - Flipbook - Page 32
GPSJ
NHS & HEALTHCARE
money that is available will be
spent. Rizwan Malik, imaging
leader, picked up on the promise
to invest in community diagnostic
centres and scanners. In
principle, he argued, this could
help to ‘left shift’ services into the
community; but in practice many
CDCs and new scanners have
been attached to acute trusts.
Nicola Haywood-Cleverly
argued there are similar issues
with virtual community and
urgent health care. Some of the
innovative projects developed
during the Covid-19 pandemic
have morphed into virtual wards
overseen by acute trusts “so
primary and community-led care
in its purest sense has been
diluted, and become part of the
old way of doing things.”
Integrated care boards were set
up to create joined up services
that still found room for both
health and social care providers
and innovative ideas. But, as
Lord Darzi pointed out, NHS
England’s policy focus and
funding 昀氀ows have not moved in
the same direction – and nor has
investment in IT.
Where’s the enabling tech?
The Treasury red book says
Reeves’ £2 billion will “run
essential services and drive NHS
productivity improvements” while
making sure that all trusts have
electronic patient records, the
NHS has better cyber security,
and there are enhancements for
the NHS App.
James Norman pointed out
it makes no mention of some of
the big, enabling technologies
that will be needed to ‘left shift’
services and loop in innovative
providers or social care. “What
has happened to the shared
care records?” he asked, as one
example.
“They were meant to connect
care, by integrating data and
letting people see information
relevant to them. But in some
places people have backed them
while in others they’ve been put
in at a minimal level and nobody
is using them. What’s the plan?”
32
Big projects, brown昀椀eld
sites
Just before the advisory board
met, the DHSC announced that
eleven ‘enabler’ groups have
been set up to feed into the 10
Year Health Plan. Encouragingly,
there is a digital group, led by
NHS England chief data and
analytics o昀케cer Ming Tang
and former national director of
transformation Tim Ferris.
However, Ferris is best known
for launching the Frontline
Digitisation programme to
complete the deployment
of EPRs at trusts and Tang
is leading on the roll-out of
Palantir’s Federated Data
Platform, which suggests the
group may focus on acute IT.
It could also go looking for
a ‘big project’. The Tony Blair
Institute for Global Change has
been making a lot of noise about
creating a single, digital health
record for every UK citizen within
昀椀ve-years.
But it has failed to answer
questions about whether it would
build on initiatives like shared
care records, or junk them.
Advisory board chair Jeremy
Nettle raised a similar issue
about the NHS App. When it was
set up, the app was billed as a
“digital front door” for the NHS.
Then NHSX decided it should
just provide identity and login
services and sign-post people
to third-party apps. Now, it’s a
mishmash of login and basic
functionality; a lot of which is
dependent on what GPs allow
their patients to see.
“The NHS App shows that
it is not just technology that
matters,” he said. “It is how it is
deployed and how it is used. You
need a roadmap and consistent
investment to deliver.”
One plan, with technology at
its heart
The advisory board also felt
that it would be a mistake to
develop a 10 Year Health Plan
with strategies to support it.
Past experience suggests these
strategies too easily become
menus of options, from which
ideas are funded or not-funded
according to political interest and
the 昀椀nances available.
Instead, the board argued
there should be one plan,
that explains how the 昀椀nance,
workforce, and technology
available will be used to enable its
direction of travel. “We shouldn’t
have a 10 Year Health Plan and
a tech strategy to go with it,”
James Norman argued. “There
should be one plan that says
how technology will be used to
deliver.”
Unfortunately, as Jeremy Nettle
pointed out, that won’t be easy
to achieve. “The NHS may not be
broken, but it’s certainly unwieldy,
and its integration with social care
is complex, and both are subject
to a lot of di昀昀erent pressures that
will need sustained e昀昀ort and
investment to address,” he said.
And what about social care?
Social care is a crisis of its
own; one that is threatening to
bankrupt councils and providers,
while not providing adults the
care they need. After the main
board meeting, Jane Brightman,
a social care expert with a special
interest in technology, said there
had been some measures for the
sector in the Budget.
These included £600 million
of new grant funding for local
authorities, an £86 million
increase to the Disabled Facilities
Grant to support 7,800 more
adaptations to homes to reduce
hospitalisations and prolong
independence, and an increase
to the Carer’s Allowance weekly
earnings limit from £151 a week
to the equivalent of 16 hours at
the National Living Wage (which
means carers can earn over
£10,000 per year).
There was also an extra
£250 million to test new ways
of working in children’s social
care next year, including a preannounced £44 million to test
allowances for kinship carers
and to roll out regional hubs to
support the recruitment of foster
carers.
Despite these measures, she
said there is signi昀椀cant concern
that this will not make a dent in
the sector’s current problems, or
GOVERNMENT AND PUBLIC SECTOR JOURNAL WINTER 2024/2025
the ones being stored up for the
future. The increase in employer
National Insurance contributions
will also hit the sector hard and
could swallow up any additional
funding on o昀昀er.
Despite Labour’s missions
to improve and its talk about
reforming health and social care,
a Fair Pay Agreement for social
care workers and a National
Care Service have not featured
in its 昀椀rst months in government.
“Both ideas are welcomed by the
sector, but too far down the road
to provide the hope that is much
needed right now,” Jane said.
